Friday, Dec 18–Cuts Leads To Reduced Health Services

County residents are receiving fewer services, said Worcester County Health Department Officer Debbie Goeller while reporting on the current state of her department to the Worcester County Commissioners Tuesday. Waiting lists for available services are a possibility, she added.

The health department lost funding from federal, state, and county sources this fiscal year.

“We are very close to $1.5 million in reductions. $1.5 million. It’s huge,” Goeller said.

That equates to 17 full-time positions, she said.

State mandated employee furloughs have also taken a toll on the health department, resulting in 793 lost days of service.

“Just because people are furloughed doesn’t mean that the need for services or the demand for services has lessened. In these economic times, it’s the opposite,” said Goeller.

The health department avoided lay-offs through a surge of public health emergency response funding to handle H1N1 virus prevention, but that funding will not last beyond the swine flu crisis, she said.

The impact of the cuts “has been fairly even handed and it has hit every department in the health department except dental,” Goeller said.

Retaining skilled staff is a concern, said Goeller, since much of the health department’s workers have in-demand skills which ensures employment elsewhere.

The health department has reduced services at its Pocomoke location one day per week and has eliminated the summer youth health service in Ocean City.

“It certainly will not be open again his summer,” Goeller said.

The health department is considering consolidating and reducing evening and weekend health service hours as well.

Employees who otherwise might have lost their jobs were shifted to vacant positions often in other areas, requiring flexibility and cross training, said Goeller.

Less funding means fewer services, according to Goeller.

Addictions counselors are now required to handle 25 percent more patients with the state caseload requirement raised from 30 to 40. Goeller compared this situation to the need for small class sizes in public schools, which means more attention for each student, or in the case of addiction services, each patient.

County residents in need of addictions services have limited choices for treatment, Goeller said, since 65 percent of the health department’s addiction patients have no health insurance.

Cutting some positions, such as the 4.5 full-time positions lost in addictions services, can affect the health department’s budget in more than one way. The department charges fees for some addictions service, and reducing positions and the number of patients served leads to a decline in that income from the previous year.

Money for tobacco control programs, including in the schools, has been reduced by two-thirds.

Funding for colorectal cancer screening has also been cut, reducing the number of colonoscopies the health department can fund for low-income residents from 33 to 23.

Core mental health services lost $40,000 this fiscal year and will lose $80,000 next fiscal year. According to Goeller, that $40,000 loss has been absorbed, but staff has yet to work out a way to handle the doubled cut next year. Money to purchase services from mental health care vendors has been also been cut, a loss of $205,000.

Goeller said she is reluctant to go with a regional approach to core services for mental health. Somerset County took that road, contracting with Wicomico County to handle those services.

“We feel pretty strongly about wanting to have that service here in Worcester County,” said Goeller.

The health department also lost a case management coordinator for developmental disabilities.

The “Just for Girls” sexual abstinence program at Snow Hill Middle School was also eliminated this year.

Goeller said the health department’s prime challenge is to come up with a way to serve the public while saving money.

“We’re going to get right on that in January and come up with some strategy. We have to do it sooner rather than later,” said Goeller.

Plans must be in place to handle H1N1 and rabies outbreaks, according to Goeller.

“That requires a lot of manpower and a lot of manpower hours,” Goeller said.

“I don’t think it’s any secret to any of us these are challenging times,” said County Commission President Bud Church.

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